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Let Us Pay Your Car Note

Your Favorite Radio Station Wants To Make YOUR CAR PAYMENT for 1 month!!!! You must present a copy of your monthly car note, and PPBC,Inc. will only pay up to $650.00 for one month only,one winner per household. If there are any differences less than the allocated $650.00 the balance will not be given to the winner in cash or credit. To qualify everything on the application form must be filled in, or you will be disqualified.

	Full Legal Name
	Current Address, City , State, Zip Code
	Birthdate
	Email Address
	Cell Phone Number
	Gender
	Your Age
	Year,Make,Model of Your Car
	Where Did You Buy Your Car
	How Much Did You Pay For Your Car
	What Is Your Monthly Payment
	Who Is Your Insurance Carrier
	Do You Plan On Purchasing A Car In The Next 6-12 Months
	Have You Read The Rules & Regulations